A year after Chargers legend Junior Seau's death, more information continues to come out about concussions, CTE and their effect on sports, especially football

Former Chargers backup quarterback Wayne Clark has been experiencing memory problems that could be associated with brain injuries caused from playing in the NFL. Sports physicians talked about concussions and other brain injuries Thursday at the American Medical Society for Sports Medicine conference in San Diego.
— John Gastaldo/U-T San Diego/Zuma Press

Former Chargers backup quarterback Wayne Clark has been experiencing memory problems that could be associated with brain injuries caused from playing in the NFL. Sports physicians talked about concussions and other brain injuries Thursday at the American Medical Society for Sports Medicine conference in San Diego.
/ John Gastaldo/U-T San Diego/Zuma Press

It was 1972 and the San Diego Chargers were in Miami playing a Dolphins squad that would go on to become the only undefeated team in NFL history.

As the Chargers’ holder, backup quarterback Wayne Clark trotted on field with the field goal unit.

But the Dolphins blocked the kick and one of Miami’s defensive backs picked up the ball.

Like everyone else, Clark ran over to try and make the tackle.

Everything after that is fuzzy, and he’s able to recount the play only because he has since seen it on video.

Clark got bumped – “more in the shoulder than in the head… it’s not a real good shot, and certainly was not a bone-jarring, brain-rattling hit,” he says.

He went down anyway, and just like that, lost all memory of the next few hours of his life.

Clark has no recollection of how he got to the locker room or onto the team plane to fly back to San Diego. He was conscious the whole time, but did not regain full awareness of his surroundings until the plane was somewhere over New Mexico or Arizona.

That was Clark’s first major concussion. He would suffer one more in his six years as a career backup in the NFL.

Both seemed inconsequential at the time.

But more than four decades later, as the issue of brain injuries in football is nearing fever pitch, Clark has become one of the first five living athletes to be diagnosed with markers of chronic traumatic encephalopathy – otherwise known as CTE.

CTE is a degenerative brain disease that sets in over a period of time after repeated bouts of traumatic brain injury. Symptoms include depression, emotional instability, disorientation, erratic behavior and memory loss.

It’s the disease that legendary San Diego Chargers linebacker Junior Seau was diagnosed with post-mortem, after he committed suicide on May 2, 2012 by shooting himself in the chest.

As we near the one-year anniversary of Seau’s death, the spotlight on brain injuries in football shines brighter than ever before.

In January, Seau’s family joined more than 4,200 other former NFL players in a wrongful death suit against NFL that is currently playing out in federal court. They allege that the NFL concealed the risks associated with repeated head injuries in football.

Wayne Clark is one of the plaintiffs in that suit. And now he’s more invested than ever.

CTE was first discovered in 2002 by Dr. Bennet Omalu, a medical examiner in Pittsburgh, Pa. who diagnosed the first case of the disease in the brain of legendary Pittsburgh Steelers center Mike Webster.

At the time of his death in Sept. 2002, Webster was suffering from dementia-like symptoms that – Omalu suspected – had resulted from several concussions and multiple other blows to the head that the offensive lineman had absorbed over a 16-year NFL career.

The autopsy and subsequent tests revealed that Omalu was correct: Webster’s brain was dotted with splotches of tau – a protein that, until then, was typically a sign of Alzheimer’s and dementia.

Omalu teamed up with prominent neurosurgeon Dr. Julian Bailes, and Wheeling, W.Va.-based attorney Robert Fitzsimmons and the trio co-founded the Brain Injury Research Institute, a center devoted to the study and prevention of traumatic brain injuries.

In the decade following Omalu’s landmark discovery of CTE, there’s been a tidal wave of public concern for brain injuries in football.

Studies have shown that concussions aren’t the only cause of CTE, but that the hundreds of smaller impacts that a football player sustains every time his head is hit or jostled on the field of play can also result in the disease over time.

“What you have to understand is it’s not only (a problem) if somebody were you to hit you in the head,” said Dr. Vladimir Kepe, one of the UCLA scientists. “Somebody can kick you or push you… you fall, you shake the brain and you do damage.

“Injury and re-injury is actually more dangerous than if you have one hit to the head and one concussion. If you keep collecting the damage, you may, over many years, collect a lot of damage.”

Since 2002, the brains of 40 former NFL players have been diagnosed with CTE.

But there was only so much that could be done to help athletes suffering from the disease because CTE could only be diagnosed post-mortem, when scientists cut up the brain and test for tau protein.

Even in the infancy of their CTE research, Bailes and Omalu knew that constraint would only take them so far.

The goal was always to try and figure out how to find CTE in the living.

“The thing about CTE was that it was great learning about it, and the exploration of the science and trying to figure out all the different issues,” said Bailes. “But after a while, it became disheartening that you could only make the diagnosis when (the subjects) were dead.

“It was people talking to you from the dead. We couldn’t help anyone.”

So two years ago, Bailes went looking for someone who could solve that problem.

Every scientist he talked to sent him in the direction of UCLA’s Dr. Gary Small, a geriatric psychiatrist who helped to devise an innovative brain scanning technology that can identify tau and amyloid beta, the two abnormal brain protein deposits that are hallmarks of Alzheimer’s disease.

Small and his colleague Dr. Jorge Barrio, also invented a substance called FDDNP, a chemical marker that binds itself to those two specific protein deposits and shows up in the PET scan.

Tau is the single most reliable sign of CTE, and in postmortem diagnoses, scientists have consistently found tau protein depositions in the amygdala region of the brain.

“The amygdala very much controls the emotions,” Barrio said. “That’s why these people with CTE tend to have strange paranoid behavior. “It’s not depression that these people have, it’s a tendency to feel that they cannot live with themselves. And that has happened, unfortunately, to very young people.”

Unlike Alzheimers, which tends to manifest itself in people aged 65 and up, CTE symptoms begin much earlier in life. University of Pennsylvania football player Owen Thomas was diagnosed with the condition postmortem at age 21. He committed suicide in 2010.

Even though CTE is most frequently associated with football, it also plagues war veterans and vehicular accident victims and that’s why doctors are approaching its study with a sense of urgency.

“We need to understand it better to try to help people protect their heads so they can live better and longer,” Small said.

Bailes’ Brain Injury Research Institute came up with $100,000 to fund Small’s study, and Bailes found a list of 20 subjects in California who were willing to participate.

Wayne Clark’s name was on that list, which shrunk to five after an initial evaluation deemed most of the participants unsuitable for the study.

The five former NFL players who eventually participated ranged in age from 45 to 73, and had played different positions – defensive line, linebacker, center, guard and quarterback. They’d all suffered from one or more concussions during their time in the NFL, and some were experiencing cognitive or mood symptoms.

The subjects were only told that they were participating in a study of the brain.

The first round of tests they went through were designed to gauge degree of depression and cognitive ability.

Then, they were injected with the FDDNP and put through the PET scan. All five were found to have markers of CTE in their brains.

Questions remain

Clark was told that his scans showed evidence of tau protein in his brain. However, unlike the other players who’d been tested, he showed no clinical symptoms of CTE.

He’d done well on the cognitive tests, and exhibited only signs of normal aging, with none of the mood disorders that the other players were suffering from.

Still, no doctor can definitively answer the question of whether the presence of tau in Clark’s brain could in time lead to the development of CTE.

“We know that NFL players have a fourfold greater risk of dying from Alzheimers,” Small said. “Wayne, even though he doesn’t have the symptoms now, he could develop Alzheimers.”

For the scientists, the discovery of tau in Clark’s brain opens more questions about CTE.

“When we see people like Wayne Clark who had just normal aging and tau in his brain on the scan, that tells us that it’s more than just the tau that’s causing the symptoms,” Small said. “There’s a lot of players who have multiple concussions who do fine. They become broadcasters later in life, they have no mental problems that we can notice.

“We think there may be genetic factors and other factors.”

The biggest knock against the UCLA study was the fact that only five people were tested. Critics say that sample size is too small and that more tests need to be conducted to determine whether the UCLA team has truly found a reliable way to test for CTE in the living.

The team doesn’t dispute that.

“They’re right. And we readily admit that. We qualified it and said, ‘It’s purely pilot data,’” said Bailes, Co-Director of the Chicago, Ill.-based NorthShore Neurological Institute.

The pilot data was essential in helping to secure grants for further study. The team wants to scan a larger number of athletes and follow them through time. They also want to study the brains of some athletes who are nearing the end of their lives so that after their deaths, their brains can be autopsied and compared to earlier scans.

“Several studies need to be done,” Small said. “We need to get a larger sample size, we need to study players who have symptoms and compare them to those who don’t have symptoms and we need to do autopsy follow up studies to match up what

we’ve seen in scans to what an individual’s brain really looks like.”

Clark has already told the scientists that he’s willing to be part of future studies. He’s also decided to donate his brain to the cause after he passes.

“I don’t feel there’s any risk at all to me to be involved with these studies,” Clark said. “I can only help myself and anybody else who’s suffering from brain trauma. Not just ex-NFL players.”

Also, in its own odd way, the results of the UCLA study were personally gratifying for Clark.

“Finding out that I had tau was kind of like getting a dirty uniform,” Clark said. “I was there. I played.

“Ultimately, I hope that will allow me to have contributed to the welfare of my ex-teammates and anybody who suffers from this.”